25 weeks, 3 days
Last Sunday I began the week like any other. Doing errands Sunday followed by family dinner Sunday night and GOT. Monday I ran around the clinic all day and then went grocery shopping for the week. Tuesday morning I saw about 10 patients, par for the course lately and then left for my OB appt. The visit did not go as I had thought it would and following I drove straight to the hospital and was admitted for 3 days of bed rest and fetal monitoring. Scary words were used like “preterm labor”…but I’m only 24 weeks?!
While there, I thought about a few thousand things. I thought about my patients who were likely freaking out to some extent as I gave them no warning that I would not be seeing them again, likely ever – despite seeing some of these folks 2-3 times a week for 6 months. I thought about baby of course, who at 1 lb. 9 oz hardly seemed strong enough to come into this world. And in fact, I was told by numerous people, to add insult to injury, that “this hospital is not equipped to birth babies until 28 weeks and [I] would be transferred if [I] went into labor”. I thought about the women I read about who at this point delivered their baby only to hold them in their arms to say goodbye. I thought about the birthing classes that I had yet to schedule. I thought that maybe this was God’s way of telling me I’m not ready to be a mother. After all, I’ve never even changed a diaper before and kids generally dislike me…
So ya, there was a lot of crying that occurred during those 3 days. Most of which I felt came from the total unpredictability of the situation.
Well not completely unpredictable. Certainly I knew that things were not going as smooth as possible. At 8 weeks I was told I had a bicornuate uterus. It was “special”; “heart-shaped”, “built for love”. Now I’ve come to realize that it is completely deformed and awful. I picture Dr. S explaining how she did a c-section on a woman once where the baby had entirely grown on one side of the uterus where the other side remained normal sized. Now that I can feel baby move and kick, I know he is completely left-sided which scares me. His feet now approach my left ribs and I worry he’ll run out of room too quickly. Women with a bicornuate uterus are more likely to go into preterm labor.
I also was diagnosed with hypothyroidism and was put on medication. I saw an endocrinologist who asked questions like have you been more tired lately? constipated? nauseous? Yes, yes, yes. I’m pregnant, afterall.
Because of the bicornuate uterus as well as the congenital heart defect I was born with, I was followed by the maternal fetal medicine specialist every 2 weeks. This meant I could stock up on ultrasound pics while the specialist told me things like, “You’re boring – let’s keep it that way”.
Things were going pretty easy until my 20 week anatomy scan. Up until then I had continued to run 4x a week with Eric in the mornings before work. And other than some pressure and GI discomfort when I got to about mile 2 or so (“poo poo cramps” as I affectionately refer to them), I felt great. That’s when Dr. L explained that my once boring 3.5 cm cervix had now shortened and funneled to 2.1 cm. They showed us that the cervix at some times could hold the full length but would funnel back and forth dynamically to the shortened length. It was scary to see baby’s head (baby is ALWAYS head down) now just 2 cm away from entering the birth canal. I was put on indomethacin, an NSAID to help “calm down the uterus” and told to stop exercising. I tiptoed around the clinic but kept working full time. Surely if running 10 miles a week was causing the cervix to shorten prematurely then stopping running would make everything ok? Wrong. We came back for weekly appts at 21 and 22 weeks — the cervix was the same – no better, no worse. I was put on progesterone suppositories which have been shown to help maintain, but not necessarily improve cervical length and told to come back in 2 weeks – apparently things were static enough that they felt I could go 2 weeks. Not to say that I went out and exercised but I felt like I could breathe a little easier. I took the dog for walks daily and thought little about it while running around at work, demonstrating planks and lunges and performing mobilizations that require some heavy lifting. That’s the mindset I found myself in at the 24 week appt. That’s when Dr. L told us the cervix had now shortened to a scary 1.2 cm. That in combination with frequent braxton hicks contractions (“What do you mean you’re having contractions!? Why didn’t you say anything”? – ummm….I’ve been getting them for 2 months and I didn’t know what they were until a week ago, I’ve never done this before – remember?)
At the hospital they gave me another round of indomethacin (my poor bowels – bed rest and that awful NSAID) and 2 betamethasone injections to help baby’s lungs mature (umm…scary!!!). After 3 days of strict bed rest, Dr. L came for a followup ultrasound. Things looked better – substantially. The cervix was back to about 2 cm. I was allowed to go home. I can’t imagine what I would’ve done if they told me I would have to spend the remainder of the pregnancy in the hospital. I hope I never have to consider that. Sure, the food was great but the bed left a lot to be desired. And the whole being woken up at 2 AM to take a pill wasn’t ideal. And I missed my puppy. Dare I say I missed work? I’ll try to remember that the next time I’m up to my eyeballs in paperwork…
So I spent the weekend resting at the river. Eric drove me while I reclined in the passenger seat. I was not allowed to carry anything or make any extra trips from the couch. Eric drove me in the golf cart to the dock where I sat and was waited on hand and foot. The rest of the time I sat on the couch watching tv. I only got up to eat or pee. And really I felt like I did as little as humanly possible – something that is surprisingly difficult.
We returned yesterday for another ultrasound. The tech left the TV on for the cervical portion (haha, rookie mistake – they always hide that from us) but to me and my “expert eye”, the cervix looked absolutely awful. It looked to be less than a cm long and to me, it looked like at the end of this intact portion it was actually pulling apart, dilating. As soon as the tech left the room I looked at Eric and we discussed that it looked worse. I started crying – what more (less) can I do? I did absolutely nothing and it got worse? I thought surely I was heading to the hospital again. But he reminded me that in the past we had expected good/bad news and Dr. L would come in and always tell us the opposite. So as he came in singing (that man is always singing), he told the tech to check again. Sure enough, the cervix looked completely different. Instead it looked normal – 3.5 cm. He said as he suspected the changes are just dynamic and the cervix was funneling back and forth still. My scary and his scary are not the same thing he said. His scary involved the cervix being completely splayed open. Yes that does sound scary…
He thinks the “irritability” of the uterus is causing the problem. I still do not understand what this means… So he wanted me to start a calcium channel blocker typically prescribed for hypertension to dilate the blood vessels and decrease said “irritability”. I casually reminded him I have vasovagal syncope. Yes, I know I’m a fun patient. So he decided to put me on the lowest dose and reminded me to drink a LOT (apparently “drink” is the drinking game b/c I just drank).
So I’m continuing bed rest. But Dr. G, my OB, made it seem like it was not the strictest. She said I could sit/lay down but to avoid being on my feet.
Dr. L said the goal is 34 weeks. He said each day we get closer to that the risk of respiratory distress, cerebral palsy, [insert any other scary baby thing], etc. goes down. At 34 weeks, I could “do jumping jacks” for all he cares. But 34 weeks is a long time away. We’re talking 60 days from today. A lifetime when you consider how slowly minutes tick by while doing absolutely nothing [productive].
So I decided to write about it. Because my mind is a scary place and it seems wrong to burden Eric with it. After all he’s got real world problems like working and coaching and making money. I already feel bad enough that he has to do all of his chores as well as do the laundry and make dinner which I normally do. And then there’s all the trivial things I have to ask of him – “Can you go get my phone charger from upstairs? Can you take my bag up? Can you take the trash out?”…it’s endless. He’s exhausted and it’s only been a week of this.
Here’s to a very boring and uneventful 60 days.